16 January 2012

10 comments:

Some interesting stuff there. But he's got a bit of a prejudice against DO's. I know some great DO's.

Med school is very difficult to get into. Lots of less qualified people get in because of family connections etc. So some better qualified people end up going to DO school because their rightful spot in an MD program was taken perhaps.

Also, sadly, a lot of medicine is quackery. If you look at studies and trials of medicines closely a lot of the claims really tell you the medicine isn't worth taking. We have medications that improve symptoms in 10% of the people that take them but cause horrible problems like weight gain to the point of obesity, yet they're advertising on TV that they're a magic cure-all. Look at the meds for depression and fibromyalgia that advertise. Just ask your doctor!!! Take this hideously expensive medicine that will make you gain 75 pounds and might make your symptoms marginally better.

I'm no fan of the magicians but medicine is coming close with some of what they're allowing the big pharma to get away with.

Everything is now a disorder that needs to be treated with drugs. Social anxiety disorder, omg, give me a pill.

Agree with this for the most part - but going too far with this runs the risk of throwing out the baby with the bath water.

Take chiropractors. If one of them starts touting all the wonderful benefits of frequent adjustments, you would be well to think "quack". But every now and then I sleep wrong or something and my back gets a kink in it. I go to my back-mechanic chiropractor, he asks where it hurts, folds me in half - *crack* and I feel great and stand straight! $35, pay on the way out, see you next time you're in pain.

Also, ascorbic acid is labeled byt establishment medicine as an "alternative" treatment, not worthy of medicines consideration. They publish clinical "studies" where patients treated with vitamin C showed no difference in reaction to a cold than did a control group. The amount of vitamin C used? 2000mg per day. Almost 20 times less per body weight than a healthy goat produces naturally in their liver. So these "studies" effectively try fighting a 3 alarm fire with a squirt gun and conclude water has no effect on a fire. Suggestions that similar studies be run with massive (30,000mg+) doses are airily dismissed as being "beneath" the medical establishment's consideration. Linus Pauling was just a nut, after all. . . .

This is mostly funny, but I am also disappointed by the DO-bashing. It is 2012, and the last state to fully accredit DO's did so in 1989 (although most did it well before then). It is ridiculous that we are still arguing over whether they are legitimate physicians. It is small-minded and, honestly, irrelevant because 1 in 5 medical students is studying at a DO school. It hardly seems rational to lump them in with naturopaths and acupuncturists that do not have the right to practice medicine when DO's are already doing so, and have been for some time, and will continue to do so in increasing numbers. I consistently respect the content posted on this blog, and I am disappointed that this was reposted with these biased and outdated claims.

I read your stuff quite a bit and feel compelled to comment on this because it hits a bit close to home. You yourself have posted about DO's you have encountered when hiring for your group (very different from the "osteopaths" that are discussed in this piece, yeah?) and the bias that was felt by a personal friend through the complete garbage he faced in trying to advance his career. Re-posting this, as hilarious as it is, simply furthers that type of stuff. Echoing what the others have said, as much as I agree that the quackary that we see on a daily basis needs to be called on what it is, please think about the other implicit messages in the work.

Please note that the MD only rule does not hold in mental health (unless you need drugs prescribed). There are lots of wonderful Master's level counselor/therapists, and for Social Work MSW is for all practical purposes the terminal degree.

Vitamin C in megadoses was debunked pretty thoroughly in the (?) 60s after Linus Pauling's enthusiasm for it gained attention. If there are good studies out there that demonstrate efficacy at any dose, please provide the link. (Emphasis on "Good" and "Efficacy.")

Pigeon & Ortho --

I admit that I didn't note any overt anti-DO statement in the cartoon (I can't recheck now since it's on SOPA-Blackout). Maybe it is there. If so, I agree that is unjustified. For the record, I've previously posted on this topic precisely and am perfectly fine with DOs.

I would caveat, however, that osteopathy's philosophic underpinnings and historic origin -- that adjustments can cure systemic disease -- does qualify as quackery. However, modern osteopathy has come into line with science based medicine.

As a current osteopathic medical student, I appreciate all the support from the readers to point out the failings of this post. Being a faithful reader myself, I strongly believe he did not intend it as a DO bash but the post struck a little too close to home that I felt compelled to comment.

People have a tendency to shun what they don't understand. Osteopathy is one of those things. You can't scientifically prove a lot of it and it is impossible to do a true "double blind" study because you can't blind the treatment team. I have, however, seen DO's do what even experienced clinicians would consider magic. I cannot explain how half of the stuff they teach us actually works and many times the professors cannot either but does it really matter what we think if it makes the patient better? Next time you think we know how the body works look up the mechanism of action of a drug, or open up a neuro textbook. Some of the "manipulations" are well researched and DO's just like to call it something else. Some of it seems like voodoo and maybe it is. And maybe, maybe people just like to be touched.

I would also like to point out that many of my fellow students are just as scientifically minded as their MD counterparts but some of us couldn't get into allopathic schools because we were not disadvantaged enough, didn't have the grades or the MCAT's or simple got screwed in the cluster that is the med school admission process (the top quarter of my class is as, if not more, intelligent than a decent portion of the students attending one of the top primary care schools in the country). Some of us chose this rout to augment their education with additional skills (which their MD counterparts do not have and which are all billable procedures). Whatever the case, I would like to think that all of us eventually begin to respect the knowledge we may be forced to learn and will become better physicians because of it.

Aargh. You know those ads we've been seeing on the TV for chronic migraine sufferers? They're from Allergan and they're to promote botox.

They've gotten FDA approval for botox for people that have migraines 15 days a month.

The only problem is studies show that botox which costs 1 to 2 grand every 3 months decreases that type of migraine by 2.3 headaches per month. And this is the kicker. Placebo works just as well in some studies.

How the hell did this get approval. A medication that really has not been proven to work at all and costs 10 to 20 dollars a day? Someone would be much better off getting a massage once a week.

Or a chiropractic adjustment. I'll bet you dollars to donuts they have better stats for migraine reduction than that!

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

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